6b Infectolab Borreliose Labor und Diagnostik engl ... - BCA-clinic

Ihr kompetenter Laborpartner 

www.infectolab.de 

Patient information: 

BCA-clinic 

Betriebs GmbH & Co. KG 

Dr. med. Armin Schwarzbach 

Facharzt für Labormedizin 

Laboratory services and diagnosis for Lyme disease and possible 

co-infections 

- The detection of tick-borne infections makes high demands on laboratory analysis in 

combination with the diagnostic findings (anamnesis) - 

It is important to detect Borrelia infections at an early stage. The earlier the detection the simpler 

the treatment measures (usually antibiotics) and the shorter the ordeal of the infected patients. 

This is how you can diagnose Lyme Disease – a Lyme disease infection progresses in 3 stages depending on 

symptoms and ailments (time specification after the tick bite): 

1. Stage I 

(after days up to weeks): “bull’s eye rash“ (“Erythema chronicum 

migrans“, only in 40-70% of all cases), Borrelia lymphocytoma, 

headache, fever, sweating, “Summer flue“ (app. 20% of all 

cases), exhaustion and fatigue, facial palsy (especially with 

children/pupils). 

2. Stage II 

(after weeks up to months): inflammation of the brain; meninges; 

spinal marrow; any nerve in the human body, inflammations of 

the joints (“arthritis”), joint and muscle pain, inflammation of the 

eye, liver and kidneys, myocarditis, pericarditis, Cardiac 

arrhythmia. 

Borrelia burgdorferi – a 

spirochete bacteria with a range 

of over 300 proven species world 

wide. 

3. Stage III 

(after months up to years): Thinning of the skin at the back of the hand, (“Acrodermatitis chronica 

atrophicans“), Borrelia lymphocytoma (ear, nose, scrotum), lethargy, fatigue, paraesthesia, cognitive 

dysfunction, muscle inflammations, joint inflammations and swelling, tendon inflammations, 

inflammation of the bursa, vasculitis, myocardinal diseases, depression. 

Symptoms of Lyme disease occur in thrusts with alternating intensity and appearance in contrast 

to a classic organic illness. Many patients also suffer from slightly higher temperature during those 

thrusts. Co-infections with other bacteria and viruses have been increases over the past years and 

often lead to a complicated course of the disease. Often the tick bite is not detected early enough 

or the acute treatment by the attending physician is not sufficient. The chronic Lyme disease 

patients often go through a true “martyrdom” as they do not only suffer from actual physical and 

mental ailments, but also from not receiving a reliable diagnosis and the fact that their illness is not 

taken seriously. 

There are three main reasons why a Lyme infection is not immediately detected in daily practice, 

so that a treatment at an early stage is inhibited: 

1. There is no bull’s eye rash (“Erythema chronicum migrans“)! Research has proven that 

this classic symptom of Lyme disease only appears in 40% to a maximum of 70% of all 

cases. 

2. No tick bite detected! Such a bite can be induced even by very small ticks (larvae). Or it 

was not detected because there was no specific skin reaction. In addition, the scientific 

community now assumes that Borrelia bacteria can also be transmitted by infected insects. 

3. Only conventional blood tests have been performed. This was either too early 

(antibodies can be tested positive only after a period of up to six weeks after the tick bite) 

or there have been absolutely no antibody production in the body or the cellular stage was 

not or not sufficiently tested (necessary tests are: Elispot ® -LTT and CD3-/CD57+ cells). 

Infectolab, ein Geschäftsbereich der BCA-clinic Betriebs GmbH & Co. KG 

Geschäftsführer: Dr. med. Carsten Nicolaus, Dr. med. Armin Schwarzbach 

Amtsgericht Augsburg HRA 15697 · Morellstraße 33 · 86159 Augsburg · Tel. +49/ 0821/ 455 074-0 · Fax +49/ 0821/ 455 074-1 

www.infectolab.de · e-mail: service@infectolab.de · Umsatzsteuer-Ident.-Nr. DE250941023 · Bankverbindung: 

Kreissparkasse Augsburg (BLZ 720 501 01) · Konto-Nr. 19885 · IBAN: DE48 7205 0101 0000 0198 85 · BIC: BYLANDEM1AUG


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The BCA-clinic Augsburg (BCA) is specialised in the diagnosis and therapy of tick-borne 

diseases. In case of a suspected tick-borne disease the diagnosis is performed by experienced 

physicians of the “Medical Partnership” cooperating with the BCA-clinic. The diagnosis is based on 

an extensive anamnesis in which precise ailments and the antecedent are recorded and reviewed 

along with a physical examination (= clinical findings). Additionally, the physician will initiate 

specific laboratory tests of your blood, which will be undertaken and analysed in the specialised 

laboratory of the BCA-clinic. 

First the laboratory diagnosis is crucial for the detection 

of Borrelia. There is a difference between the tests of the 

humoral (antibodies) and cellular level (lymphocytes, 

NK-cells). Both levels have to be examined at the same 

time when a Lyme disease or an apparent illness is 

suspected. 

1. Laboratory testing of the humoral level (antibodies): 

Borrelia IgM- and IgG-EIA (Enzymimmuno-assay) 

as well as Borrelia IgM- and IgG-Immunoblot 

2. Laboratory-testing of the cellular level: 

Elispot ® -LTT (Borrelia Elispot Lymphocyte Transformation 

Test), CD3-/CD57+ cells (NK-cells) 

Explanations of these tests: 

1. Antibodies – humoral level: In case of the Borrelia antibodies 

examinations up to 19% of the antibodies results in the EIA are 

falsely negative due to the minimal sensitivity (responsiveness) 

of the EIA in contrast to the Immunoblot. Therefore it is 

essential to check the Borrelia IgM- and IgG-Immunoblot along 

with the Borrelia IgM- and IgG-EIA (even with a negative EIA)! 

Important: The laboratory has to always tests for VlsE (Variable 

major protein-like sequence Expressed) in EIA and 

Immunoblot. VlsE describes the characteristics of the Borrelia 

as a “chameleon“, which permanently changes the surface 

structure VlsE in vivo to resist the detection via the immune 

system. VlsE has the highest sensibility for the antibody search! 

Armin Schwarzbach M.D., 

medical specialist for laboratory medicine, 

head of the BCA laboratory and 

specialist for Lyme and co-infections. 

Beware of positive antibodies constellations! 

Borrelia IgM- as well as IgG-antibodies can remain in the body for 

months or years even without an active Lyme disease infection. 

Hence a positive Borrelia antibodies test does not give any evidence 

of the activity of a Lyme infection, but gives only one conclusion: There must have been a tick bite or tick 

bites in the past during which Borrelia bacteria have been transmitted – no more or less! 

2. Cellular level: 

a) The Borrelia Elispot ® -LTT provides information about the current activity of the Borrelia bacteria and is 

20 to 200 fold more sensitive than a EIA-antibodies test. 

b) The CD57+ cells indicate the extent of immune suppression during a chronic Lyme disease and are the 

prognostic factor during and after the antibiotic treatment. 

The complete laboratory diagnosis is very complex and - considering the co-infections - has to be 

put together like a mosaic. This demands experienced Lyme disease analysts who can diagnose 

and evaluate all other infections as well. 

Armin Schwarzbach, M.D., PhD, is head of laboratory medicine and diagnostics in the BCA.-clinic. 

Dr. Schwarzbach is very experienced in laboratory medicine and has been a specialist in Lyme 

disease and co-infections for years. 

The medical laboratory diagnosis is primarily orientated on the guidelines of the German Society 

for Hygiene and Medical Microbiology (MiQ12 Lyme-Borreliose). However, the complexity of a 

Lyme disease infection is not sufficiently covered by this and needs additional laboratory testing.


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Therefore further internationally accepted methods are applied which are of considerable 

importance for the patient before and after the therapy (e.g. for the cellular level: Elispot ® -LTT and 

the CD3-/CD57+ cells). 

The laboratory integrated in the BCA for the analysis of vital parameters ensures, especially in the 

case of the medical treatment (e.g. infusion therapy), that the physicians of the medical 

partnership make further therapy decision as soon as possible according to the blood results. 

In practice, the following laboratory constellations indicate a Borrelia infection: 

(1) Positive antibody detection and positive cellular results 

(Elispot ® -LTT and/or CD57+) – often active infection 

(2) Positive antibody detection without positive cellular test findings – What kind of indications 

are shown by the clinical findings (symptoms)? 

(3) Negative antibodies detection, but positive cellular test results 

- Indication for an active Lyme disease at an early stage, but also chronic stage – what 

kind of indications are shown by the clinical findings (symptoms)? 

Attention: A negative antibody detection in the EIA and/or Immunoblot does not give evidence of 

a Lyme infection! Because: the antibodies production of a Lyme disease in stage I needs several 

weeks, 10 to 14 days at a minimum. Thus the immediate measurement of cellular activity in 

Elispot ® -LTT is a compulsory necessity, as normally the cellular activity precedes the humoral 

activity in stage I of a Lyme disease infection. 

In practice the following combinations of blood tests have proven useful: 

Laboratory diagnosis stage I 

(Costs: 393,44 € plus extra charges.) 

1. Borrelia IgG- and IgM-EIA incl. VlsE 

2. Borrelia IgG- and IgM-Immunoblot 

incl. VlsE 

3. Borrelia Elispot ® -LTT 

Laboratory diagnosis stage II and 

stage III (Costs app.: 544 € plus extra charges.) 

1. Borrelia IgG- and IgM-EIA incl. VlsE 

2. Borrelia IgG- and IgM-Immunoblot 

incl. VlsE 

3. Borrelia Elispot ® -LTT 

4. CD3-/CD57+ cells 

Necessary “Staging“ (evaluation of progression) of Lyme disease during and after an antibiotic or 

holistic approach to therapy: The above mentioned parameters also have to be checked during 

Lyme therapy. 

Recommended laboratory diagnosis during the therapy: 

Stage I 

Performance of above mentioned 3 tests 

4 weeks after beginning of therapy and 8 

weeks after the end of therapy. 

Stage II and III 

Performance of above mentioned 4 tests after 

beginning of therapy every 8 weeks as well as 

8 weeks after end of therapy. 

For explanation: Borrelia antibodies or titer cannot be “eliminated”, but they can exist in the 

blood for months or even years. After a successful antibiotic therapy Elispot ® -LTT as well as 

CD57+ cells should have come to a “normal” level 8 weeks after the end of therapy. But: Inspite 

of a symptom free status after treatment there might be still positive findings of Elispot ® -LTT 

and/or CD57+ cells, so the patient should be considered for a “monitoring” of the activity tests and 

possible future symptoms. Otherwise there will be the risk of a relapse, a new infection or a coinfection. 

It should be noted that laboratory parameters alone do not give a definite proof of Lyme disease, 

but very important evidence and details about a possible infection. The parameters are also very 

important to make decisions about the duration and success of therapy.

Adjoining is an overview 

of relevant diagnostic 

parameters of tick-borne 

diseases. 

These may be extended 

or limited individually 

during an extensive 

consultation meeting with 

your attending physician 

(e.g. in case of prefindings). 

Based on the coinfections 

questionnaire 

indications are 

established if such 

additional laboratory tests 

are necessary. 

An overview of prices can 

be found in the 

attachment “Order for 

laboratory tests with 

declaration of consent“ for 

patients. 

Note: The laboratory analysis is only one part 

of a comprehensive diagnosis. The clinical 

report based on an extensive anamnesis and 

a physical examination is the crucial part. The 

experienced physicians of the cooperating 

Medical Partnership know the broad range of 

possible disease patterns, which can also 

become noticeable as „unspecific general 

symptoms“ (note adjoining chart). 

Generally, the laboratory diagnosis causes the following costs: 

Laboratory costs 

1. for Borrelia IgM- and IgG- antibodies including VLSE, 

Borrelia Elispot ® -LTT and CD3-/CD 57+ T-lymphocytes 

with blood sampling and special tubes app. 544 € 

2. Basic laboratory (blood count, liver-kidney-clotting) app. 80 € 

3. Possible necessary additional examination when suspicion of coinfections 

(Each test app. 61 – 97 €): up to app. 945 € 


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infectolab laboratory diagnostic services: Special tests and know-how in detection 

of Lyme disease and possible co-infections 

Basis diagnosis Lyme disease Komplicating Viruses / Bacteria (Antibodies) 

Borrelia IgG-EIA (incl. VlsE) Herpes Simplex Virus-IgG/-IgM 

Borrelia IgM-EIA (incl. VlsE) Mycoplasma pneumoniae-IgG/-IgA/-IgM 

Borrelia IgG-Immunoblot (incl. VlsE) Epstein Barr-Virus-IgG/-IgM 

Borrelia IgM-Immunoblot (incl. VlsE) Chlamydia pneumoniae-IgG/-IgA 

Borrelia Elispot-LTT * Chlamydia trachomatis-IgG/-IgA 

CD3-/CD57+ -T-Lymphocytes Helicobacter IgG/-IgA 

Borrelia DNA-PCR Toxoplasmosis IgG/-IgM 

Yersinia IgG/-IgA 

Liver - kidney - blood count - electro- 

lyte - muscle - fats - hyperthyroidism Tick-borne Co-infections (Antibodies) 

" Organ profile " (Blood count, sGOT Ehrlichia-/Anaplasma-IgG/-IgM 

sGPT, sGGT, LDH, CHE, Bilirubin Babesia IgG 

total, Amylase, Lipase, CK, Creatinine Rickettsia IgG/-IgM 

Urea, Sodium, Potassium, TSH basal Bartonella IgG/-IgM 

Uric acid Tick-borne Co-infections/Viruses/ 

Cholesterol, Triglycerides, HDL, LDL Bacteria (Activity tests) 

TSH basal, free T3, free T4 Ehrlichia/Anaplasma-Elispot-LTT * 

MAK, TAK, TRAK Chlamydia pneumoniae-Elispot-LTT * 

CRP Chlamydia trachomatis-Elispot-LTT* 

Autoantibodies Tick-borne Co-infections 

ANA titer (PCR direct detection) 

Anti-CCP Ehrlichia/Anaplasma 

c-/p-ANCA Barbesia microti 

C3-/C4- complement Bartonella henselae 

ENA Rickettsia 

ds-DNS Chlamydia in Sputum 

Mykoplasma in Sputum 

"Diarrhea / Celiac disease profile" Urine testing for heavy metals 

Antigliadinin-IgA-Antibodies, tissue- Aluminium, Cadmium, Lead 

transglutaminase-IgA-Antibodies, IgA Mercury, Copper, Creatinine 

* Lymphocytes Transformation Test 

Example: Range of services for laboratory tests for Lyme disease and possible co-infections (complete M3- 

Laboratory) All laboratory parameters of clinic chemistry, of infection serology, of autoimmune and hormone 

diagnostic as well as microbiology are also available. 

Note: 

• Elispot- and CD3-/CD57+ are principally not covered by health insurances! 

• The unit prices for different laboratory tests result from the laboratory order form in the attachment: 

blood samplings and special tubes will be billed separately.

Laboratory tests of possible co-infections 


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Laboratory tests of possible co-infections have an increasing importance when adequate evidence 

exists (BCA co-infections sheet). Especially Ehrlichia/Anaplasma, Babesia, Bartonella, Rickettsia, 

Chlamydia and Mycoplasma are to be named. 

Because: numerous symptoms of the co-pathogens overlap the same symptoms of Lyme disease 

patients. Without an exact knowledge of a patient’s possible co-infections the therapist cannot 

make a exact decision about the antibiotic therapy. Not all co-infections can be treated by the 

generally used antibiotics for Lyme disease. However, the testing for co-infections can induce 

extensive additional laboratory costs (up to 945€). But these are justified by the additional security 

in the diagnosis and especially by the correct antibiotic decision, i.e. more success in antibiotic 

therapies as well as generally less expensive costs for medication during the antibiotic therapy 

(vs. the “classical” antibiotic therapy of chronic Lyme disease). 

Apart from the LTT for Borrelia further cellular activity tests for Ehrlichia/Anaplasma, Chlamydia 

pneunomiae and Chlamydia trachomatis have been developed in the meantime (Babesia cellular 

activity testing is coming soon) and can therefore be determined with Elispot-LTT-technique. With 

the help of this new Elispot ® -LTT many activities of Chlamydia and Ehrlichia have been detected 

in the BCA! A serum examination concerning co-infections is perfomed at the same time. There 

are now well standardised antibody tests for Chlamydia, Mycoplasma, Ehrlichia, Bartonella, 

Rickettsia, Babesia, Yersinia etc. The same applies here as well as with the Borrelia-LTT: the 

antibodies alone do not have any significance towards the activity of an infection – but the 

Elispot ® -LTT is significant as it attests the high-specific interferon release against the respective 

co-pathogen in the blood. 

It should be noted that in some cases it is the co-pathogen itself which is responsible for the 

symptoms and not the Borrelia infection: e.g. Chlamydia cause diseases patterns such as Morbus 

Alzheimer, Multiple Sclerosis, fibromyalgia, Chronic Fatigue Syndrome (CFS), myocardinal 

infarcts, strokes, vasculitides, visual disturbances. 

The Lyme infection may well have been treated successfully with antibiotics, but the co-infection 

might not have been destroyed by it. Therefore, an exact anamnestic documentation of the 

symptoms during the therapy is necessary before, during and after a Borrelia infection. 

Further information regarding the importance of co-infections can be found in the separate 

information for patients: „Increasing importance of co-infections for Lyme disease patients” (article 

by Armin Schwarzbach, M.D., PhD). 

Laboratory transmittals 

In case of a suspected tick-borne disease physicians have the opportunity to execute specific 

laboratory analyses in cooperation with the BCA. The blood kits contain special anamnestic 

questionnaires by the BCA and a questionnaire to check for co-infections. The patient should fill 

out these questionnaires and send them to the BCA together with the blood kits. 

We are delighted to provide interested physicians with further information about possibilities in 

terms of collaboration and co-operation to provide a successful treatment for patients suffering 

from tick-borne diseases. Especially for the diagnosis and therapy of chronically ill patients, who 

are not living in the Augsburg area we can coordinate the procedure of the treatment with the 

attending physician at home if wanted. However, in case of complicated symptoms and severe 

illness patterns we recommend the physicians of the Medical Partnership which cooperates with 

the BCA for the first diagnosis and therapy plan preparation. We also recommend the Lyme


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Disease “Intensive Treatment and Rehabilitation” Program of the BCA, which is a special Compact 

Treatment clinic for chronically ill patients here in Augsburg. 

The BCA regularly offers seminars and workshops, as well as exchange and sharing of 

experiences to interested physicians and cooperation partners. 

Below you will find as attachments further information regarding the laboratory tests on the 

cellular level (Borrelia Elispot ® -LTT, CD3-/CD57+ cells and the Elispots for Chlamydia and 

Ehrlichia) as well as the order form for laboratory tests with declaration of consent for the BCA. 

Diagnostik Diagnostis + Therapie Therapy 

„Ä „ Medical rztliche 

Partnerschaft Partnership“ “ * 

- 9 4 behandelnde attending phisicians Ärzte - 

f ü r alle for medizinischen 

all medical 

Leistungen services 

Dr. med. C. Nicolaus, praktischer Arzt, 

& Dr. med. A. Schwarzbach, Laborarzt, 

ä rztliche Partnerschaft f ü r zecken - 

ü bertragene Erkrankungen * 

Attachments 

unterst Accompanying ü tzende 

Therapies - Therapien 

spezialisiertes 

Specialized 

Laboratory Labor 

inkl. Incl. Intensivbehandlung Chronic Lyme u. fü r Zeckenü for tick-borne bertragene 

Compact Ganztagesbetreuung Treatment Erkrankungen diseases an co-infections (Borreliose 

(spezielles (special weekly Wochenprogramm program und das breite Spektrum der 

for fü lyme disease patients Co -Infektionen) 

B - C- A Borreliose Centrum Augsburg Betriebs GmbH & Co. KG 

( www.B - C - A.de ) 

• Further information regarding the laboratory tests on cellular levels: Borrelia Elispot ® -LTT, 

CD3-/CD57+ cells, Chlamydia Elispot ® -LTT and Ehrlichia Elispot ® -LTT 

• Order form for laboratory tests with declaration of consent 

Note Range of Services: 

• All medical services (diagnosis, therapies, 

therapy plans and medical therapy 

monitoring) are provided by the attending 

physicians of the „Medical Partnership“ will 

be billed to the patient on a private medical 

basis (according to the Medical Association’s 

professional code of conduct in Bavaria). 

• All laboratory services will be billed from 

BCA-clinic Betriebs GmbH & Co. KG 

Borrelia Elispot ® -LTT 

- Determination of actual activity in the blood regarding Borrelia burgdorferi 

A Borrelia infection simultaneously leads to an activation of T-lymphocytes lateral to the humoral 

immune response. The T-cellular immune answer vanishes as soon as the Lyme disease infection 

is not active anymore. 

A control of success of a Lyme infection therapy is not possible via Borrelia antibodies, as the 

“titer” or the antibodies can still be found in the blood for years after a cured infection. Additionally, 

in the first stage of Lyme disease (e.g. “bull´s eye rash” or “summer flu” after a tick bite) antibodies 

can only be detected and measured after several weeks or not at all. 

The diagnostic gaps are suggested to be Borrelia according to the Elispot, which measures the 

actual activity regarding Borrelia burgdorferi with chronic and also acute Lyme disease infections. 

The Elispot is so sensitive, that it can even detect a single Borrelia reactive T-cell in the blood. The 

Elispot is 20- to 200-fold more sensitive than an ELISA-test on Borrelia and is able to find 1 

reactive cell under 100.000 lymphocytes. 

The Elispot of Borrelia is very important for controlling a therapy of a chronic or acute Lyme 

infection. In general the Elispot is negative approximately 6 to 8 weeks after the end of a 

successful therapy.


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Advantages of the Borrelia Elispot-LTT (- as performed in the BCA -) in contrast to traditional 

lymphocyte transformation tests: 

• The result is obtainable within 2 days (LTT: 1 – 2 weeks) ! 

• The use of cell stabilising CPDA tubes means a stability of 3 days for the measured cells 

(LTT: Heparin blood only 24 hours) ! 

This offers a significant improvement of the stability of the examined cells and a fast decisionmaking 

possibility for Lyme disease therapists to extend the duration of a therapy or start a new 

treatment approach! 

Borrelia Elispot: 

Materials: 2 x 8.5 ml CPDA-tubes (kept at room temperature, do not refrigerate) 

Time required for analysis: 2 days 

Billing according to GOÄ: Number 3694 (3 different antigen approaches) factor 1.5 (3x 

49.84 €) + number 4003 (Lymphocytes isolation) Factor 1.5 (34.97 €) 

- total sum: 184.49 € 

Indications: 

- Diagnosis of a chronic Lyme disease 

- Diagnosis of a acute Lyme disease 

- Decision-making regarding the length of therapy 

- Control of therapy after a Lyme disease therapy 

Borrelia CD 57+ cells 

- Determination of chronic activity in the blood regarding Borrelia burgdorferi 

A chronic progression (stage III) of a Lyme infection leads to a weakening of the immune system. 

This is reflected by the decrease of the CD3-/CD57+ NK-cells in case of chronic Lyme disease. 

The CD3-/CD57+ cells are a subpopulation of the Natural-Killer-Cells (NK-cells). 

A decrease of the CD57+ cells indicates (an untreated) chronic or not sufficiently treated chronic 

Lyme disease and does not appear in cases of a acute Lyme infection (e.g. “bull’s eye rash“ or 

“summer flu“ after a tick bite). 

The CD57+ cells reflect the degree of activity of a chronic Lyme disease and decrease to a normal 

level after a successful Lyme disease therapy (after the end of treatment). 

In contrast there is no decrease of CD57+ cells with clinical similar diseases, such as Multiple 

Sclerosis (MS), Systemic Lupus Erythematosus (SLE) or an Amyotrophic Lateral Sclerosis (ALS). 

In addition there is no significant fluctuation of CD57+ cells throughout the day. 

CD57+ cells are appropriate laboratory parameters in cases where chronic Lyme disease is 

suspected and for therapy monitoring. These should be measured parallel to the Borrelia Elispot, 

which reflects the actual T-cellular activity. 

Advantages of the CD57+ cells determination of Borrelia: 

1. The result is available within 2 days ! 

2. The use of cell-stabilising Heparin-tubes assures a stability of the measured NK-cells for 2 

days! 

In combination with the Borrelia Elispot this results in a significant improvement of the stability of 

the examined cells and a fast decision-making possibility for Lyme disease therapists to extend 

the duration of a therapy or start a new treatment approach! 

CD3-/CD57+ NK-cells:Material: 1 x 10 ml Heparin-tube + 1 x EDTA-blood/blood count-tube (kept 

at room temperature, do not refrigerate) 

Time required for analysis: 2 days


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Billing according to GOÄ: Number 3696 x 2, factor 1.5 (99.68 €) + number 3550/3551 (big 

blood picture), factor 1.5 (6.99 €), total sum: 106,68 € 

Indications: 

- Diagnosis of chronic Lyme disease 

- Decision-making regarding length of therapy 

- Control of therapy after a Lyme therapy 

Chlamydia Elispot ® -LTT 

- Determination of actual Chlamydia activity in the blood 

Chlamydiae are intracellular pathogens, which can be the reason for various medical conditions. 

There are two sub species: Chlamydia pneumoniae and Chlymydia trachomatis. 

Chlamydia pneumoniae is mainly an airborne infection and is transmitted from humans to humans. 

Chlamydia pneumoniae has a very high degree of penetration. The following ailment patterns are 

associated with the disease: e.g. inflammation of joints, tendonitis, Multiple Sclerosis, fibromyalgia, 

Morbus Alzheimer, chronic fatigue syndrome (CFS), arteriosclerosis. An immune suppression is a 

risk factor for Chlamydia infections amongst others also for chronic infections, such as Lyme 

disease. 

Chlamydia trachomatis is transmitted sexually from humans to humans and causes the following 

medical conditions: sterility, urethritis and cervical inflammation, acute conjunctivitis (“swimming 

pool conjunctivitis”), inflammation of joints and tendonitis after the infection. An immune 

suppression is a risk factor here as well. 

A Chlamydia infection leads to an activation of the T-lymphocytes parallel to the humoral immune 

answer (Chlamydia IgG- and Chlamydia IgA-antibodies). The T- cellular immune answer vanishes 

as soon as the Chlamydia infection shows no activity. 

The Elispot on Chlamydia trachomatis or Chlamydia pneumoniae therefore shows the actual 

activity of these diseases. The Chlamydia pneumoniae- and Chlamydia trachomatis-Elispot helps 

with the diagnosis of these infections and also is a means of successful control during the course 

of the therapy. 

Advantages of the Chlamydia Elispot: 

• The result is available within 2 days ! 

• The use of cell-stabilising CPDA tubes means a stability of up to 3 days for the measured 

T-cells ! 

• The right choice of a specific antibiotic therapy ! 

Chlamydia pneumoniae and/or Chlamydia trachomatis Elispot: 

Material: 2 x 8.5 ml CPDA-tubes (kept at room temperature, do not refrigerate) 


Billing according to GOÄ (single price for Chl. Pneumoniae/ Chl. Trachomatis): 

Number 3694, factor 1.5 (49.84 €) + number 4003 (lymphocytes isolation), factor 1.5 

(34.97 €), sum for single test: 84.81 € 

Indications: 

- Diagnosis of a Chlamydia infection 

- Decision-making regarding length of therapy 

- Control of therapy success after a Chlamydia-specific therapy


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Ehrlichia/Anaplasma Elispot ® -LTT 

- Determination of actual activity in the blood regarding Ehrlichia/Anaplasma 

Ehrlichia or Anaplasma are intracellular pathogens, which can be found obligatory within the white 

blood cells. Ehrlichia are transmitted to the human by ticks contaminated with Ehrlichia 

(approximately 6% of all ticks are contaminated with the pathogen). 

The symptoms of an Ehrlichia infection begin with flu like problems and express themselves with 

strong headache, which are very often located “behind the eyes”. Furthermore muscle aches and 

numerous neurologic symptoms may be caused by Ehrlichia. Rarely skin rashes on various parts 

of the skin can be found, also on the palm of the hand and soles of the feet. 

An immune suppression is often the risk factor for an Ehrlichia infection amongst others 

depending on age, but also on chronic infections like Lyme disease. 

In the case that Ehrlichiosis (illness pattern of an infection with Ehrlichia) existing parallel to a 

Lyme infection it is called co-infection. According to the latest scientific literature additional coinfections 

with Ehrlichia should be taken into account in ca. 30% of all chronic Lyme disease 

patients. 

An infection with Ehrlichia leads to an activation of the T-lymphocytes parallel to the humoral 

immune answer (Ehrlichia-IgM- and Ehrlichia-IgG-antibodies). The T-cellular immune answer 

vanishes as soon as the Ehrlichia infection shows no activity. 

The Elispot on Ehrlichia/Anaplasma measures the actual activity of this disease. 

The Ehrlichia-Elispot helps with the diagnosis of this infection and also is a means of a successful 

control during the course of the therapy. 

Advantages of the Ehrlichia Elispot: 

• The result is available within 2 days ! 

• The use of cell stabilising CPDA tubes means a stability of up to 3 days for the measured 

T-cells ! 

• The right choice of a specific antibiotic therapy ! 

Ehrlichia Elispot: 

Material: 2 x 8.5 ml CPDA-tubes (kept at room temperature, do not refrigerate) 


Billing according to GOÄ: Number 3694, factor 1.5 (49.84 €) + number 4003 (lymphocytes 

isolation), factor 1.5 (34.97 €), total sum 84.81 € 

Indications: - Diagnosis of an infection with Ehrlichia 

- Decision-making regarding the length of therapy 

- Control of therapy success after an Ehrlichia-specific therapy 

Attachment: Order form for laboratory tests with declaration of consent 

- This order is to be filled out by your physician and has to be signed and dated by you in case of 

an order to the infectolab laboratory. The costs of the respective laboratory order result from the 

following individual prices (GOÄ), plus possible side costs for blood sampling, blood tubes, 

shipment.

Patient’s last name, first name Date of birth 

Laboratory Tests Order Form 

Please write in CAPITAL LETTERS Male □ Female □ 

House No., Street 

Post Code/ZIP City Country/State 

Phone Email 


Seite 10 

Please forward my test results to my home/family doctor 

(name, address of doctor’s practice) 

House No., Street 

Post Code/ZIP City Country/State 

Phone and Fax or Email 

I would like the following laboratory parameters (diagnostics) to be tested: 

Euro € Euro € Euro 

€ 

o Borrelia Elispot LTT 184.49 o Chlamydia pneumoniae Elispot LTT 84.81 o CCP- Antibodies 39.34 

(CPDA) (CPDA) (Serum) 

o CD3-/CD57+ Cells 106.68 o Chlamydia pneumoniae-Antibodies 61.20 o ANA-Titer (Serum) 44.60 

(Heparin+EDTA) (Serum) o ENA-Screening (Serum) 157.38 

o Borrelia IgG- and IgM-EIA 69.07 o Chlamydia trachomatis Elispot LTT 84.81 o ds-DNS- Antibodies 

(Serum) 

44.60 

(Serum) (CPDA) o c- und p-ANCA (Serum) 89.19 

o Borrelia IgG- and IgM-Blot 139.88 o Chlamydia trachomatis-Antibodies 61.20 o CRP (Serum) 17.49 

(Serum) (Serum) o “Diarrhoea/Coeliac Profile“ 97.04 

o Borrelia-DNA-PCR 148.63 o Mycoplasma-Antibodies 123.27 (Gliadin-IgA-Antibodies, 

(EDTA,Blood Urine, Aspirate, 

Biopsy) 

(Serum) Tissue transglutaminase-IgGo 

Ehrlichia Elispot LTT 84.81 o Yersinia IgG- und IgA-Blot 139.88 Antibodies, total IgA) 

(CPDA) (Serum) 

o Ehrlichia-IgM- and IgG Antibodies 89.19 o Rickettsia-IgG-Antibodies 89.19 o “Organ Profile“ 86.58 

(Serum) (Serum) (Full Blood Count, GOT, GPT, 

o Ehrlichia-DNA-PCR 174.87 o Rickettsia-DNA-PCR 218.58 GGT, LDH, Che, Bilirubin 

(EDTA) (EDTA) total, Amylase, Lipase, CK, 

o Bartonella-IgG Antibodies 89.19 o EBV-Antibodies 110.17 Creatinine, Urea, Sodium, 

(Serum) (Serum) Potassium, TSH basal, Quick, 

o Bartonella-DNA-PCR 174.87 o HSV- Antibodies 41.97 PTT, AP) 

(EDTA) (Serum) o Protein (Serum) 20.11 

o Babesia-IgG-Antibodies 44.60 o CMV- Antibodies 47.22 (Total + Electrophoresis) 

(Serum) (Serum) o Lipids (test on empty stomach) 14.00 

o Babesia-DNA-PCR 174.87 o Toxoplasmosis- Antibodies 82.19 (Cholesterol, Triglyceride, 

(EDTA) (Serum) HDL, LDL) 

Please always take 2 CPDA tubes o Coxsackie- Antibodies 120.67 o Thyroid Gland (Serum) 65.58 

of blood for the Elispot LTT!!! (Serum) (TSH basal, fT3, fT4) 

o Thyroid-Antibodies 

(Serum) (MAK,TAK,TRAK) 

126.77 

o Heavy-Metals-Testing 

From Urine in case of Lyme 

(Aluminium,Cadmium, Lead, 

Mercury, Copper, Creatinine) 

182.75 

o Other Tests: 

…………………………………………………………………………………………………………………………………………………………………… 

Declaration of Consent: 

I herewith declare that I am fully insured by a compulsory medical health insurance company. I also acknowledge that the insurance 

company, which I am insured with, provides sufficient cover for medical treatment and diagnostics. I wish to receive further medical 

services, which might not be included in my insurance cover, and accept laboratory services with factor 1.5 

I am aware that I have to pay the costs for laboratory tests myself, and that I will receive an invoice from the Borreliose Centrum 

Augsburg for any undertaken laboratory tests. I am aware of the costs for all laboratory parameters I wish to be tested. The test 

results will be send to my doctor (either at the BCA or my family doctor at home). 

I agree that all laboratory parameters will be tested in and invoiced by the Borreliose Centrum Augsburg according to the German 

Medical Fee Schedule (GOÄ 3500-4787, factor 1.5). Furthermore, I agree to send a pre-payment for all laboratory tests in advance. 

Results will not be send out until the full invoice is paid. 

Date, Signature: ………………………………………………………………………………………….………

6b Infectolab Borreliose Labor und Diagnostik engl ... - BCA-clinic

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